Infectious Diseases Affecting Urinary and Reproductive Systems

Chapter 24

Infectious Diseases Affecting Urinary and Reproductive Systems

•Sexually transmitted diseases (STDs) remain a health problem in the United States and around the world, the seriousness of which is underscored by a number of infections.

24.1 The Structure of the Female and Male Urinary System

•The urinary system removes waste products from the blood and helps maintain homeostasis

•The urinary system harbors an indigenous microbiota

•The distal region of the urethra is usually colonized by a variety of bacterial species

•Many of the defense mechanisms operating in the male urethra are similar to those of the female urethra

24.2 Urinary Tract Infections Caused by Bacteria

•Infections of the urinary tract are the second most common type of infection in the body

•Occur primarily in the urethra and bladder

•1/3 to 1/2 of humans suffer a UTI at some time in their lives

•Most urinary tract infections involve the urethra or bladder

•UTIs have similar signs and symptoms

•Urethritis

•Cystitis

•Prostatitis

•Pyelonephritis

•Leptospirosis is azoonotic diseaseaffecting the kidneysand other tissues

24.3 The Structure and Indigenous Microbiota of the Female and Male Reproductive Systems

•The male and female reproductive systems consist of primary and accessory sex organs

•Portions of the male and reproductive systems have a microbiota

24.4 Non-Sexually Transmitted Infections of the Reproductive System

•Common vaginal infections come from indigenous microbiota

•Changes in the microbiota affect the vaginal environment

•Bacterial vaginosis

•Vaginal candidiasis

24.5 Sexually Transmitted Diseases Caused by Bacteria

•STDs continue to be a major public health challenge in the United States

•STDs were commonly called venereal diseases (venerea = referring to Venus, the Roman goddess of love)

•Chlamydial urethritis is the most frequently reported STD

•Can be asymptomatic

•Chlamydial urethritis (chlamydia) is caused by Chlamydia trachomatis

•Chlamydia is the most commonly reported notifiable disease in the United States

•Chlamydia is one of several diseases known as a non-gonococcal urethritis (NGU)

•85–90% of infected individuals are asymptomatic

•C. trachomatis cannot make its own ATP and must rely on the host cell for energy

•It has two phases: the infectiouselementary body andthe noninfectious

reticulate body

•Spreading to the fallopian tubes can cause salpingitis

•Left untreated, it can cause PID

•Males complain of painful urination and watery discharge

•It can cause infertility in males

•Chlamydia can also occur in the pharynx or anus

•Newborns can contract chlamydial ophthalmia during delivery

•Infection can be detected by a fluorescent antibody test or DNA analysis

•Species of Chlamydia are used to investigate the evolution of pathogenicity

•Gonorrhea Can Be an Infection in Any Sexually Active Person

•Gonorrhea is caused by Neisseria gonorrhoeae

•Gonorrhea can also affect the

•reproductive organs

•pharynx

•rectum

•eyes

•Infants can contract gonococcal ophthalmia while passing through the birth canal

•In females it can spread to the fallopian tubes, causing

•pelvic inflammatory disease (PID)

•possible sterility

•ectopic pregnancy

•salpingitis

•Many affected females areasymptomatic

•Males experience

•tingling of the penis

•pain when urinating

•penile discharge

•swollen lymph nodes

•painful testicles

•It can cause infertility in males

•Syphilis Is a Chronic, Infectious Disease

•Syphilis is one of the top five most reported microbial diseases in the United States

•It is caused by Treponema palladium, a spirochete for which humans are the only host

•Primary syphilis is characterized by a lesion (chancre) where the bacteria entered the body

•Secondary syphilis involves

•fever

•skin rash

•swollen lymph nodes

•A chronic latent stage of3–30 years follows in which relapses of secondarysyphilis occur

•Tertiary syphilis involves formation of gummas that can cause

•weakening and bursting of blood vessels

•degeneration of spinal cord tissue

•brain damage leading to personality and judgment changes and insanity

•Congenital syphilis can occur in the fetus of a pregnant woman, leading to

•stillbirth

•birth defects like Hutchinson’s triad

•Other Sexually Transmitted Diseases Also Exist

•Chancroid Causes Painful Genital Ulcers

•Chancroid (soft chancre) is caused by Haemophilus ducreyi

•It is common in areas with low public health standards and tropical climates

•A papule forms at the entry site that fills with pus and breaks down

•This leaves a painful, bleeding ulcer

•Lesions often form on the penis in men, labia or clitoris in females

•Ureaplasmal Urethritis Produces Mild Symptoms

•It is an NGU caused by Ureaplasma urealyticum (T-mycoplasma)

•Symptoms are similar to those of gonorrhea or chlamydia but are often mild

•Infertility can occur in men, salpingitis in women

•U. urealyticum can colonize the placenta during pregnancy, causing

•miscarriage or

•premature birth

•Lymphogranuloma venerium (JGV) is caused by a different serotype of C. trachomatis than chlamydia

•It is more common in men than women

•It is common in Southeast Asia and Central and South America

24.6 Sexually Transmitted Diseases Caused by Viruses and Parasites

•Some herpesviruses are associated with reproductive system infections

•The herpes simplex viruses cause benign infections

•Genital herpes

•Some papillomaviruses are associated with genital warts and cancer

•Genital warts (condylomata) are often transmitted through sexual contact

•Some strains of HPV are associated with cervical cancer

•They may be transmitted to newborns during delivery

•Trichomoniasis is the most common STD in young, sexually active women

•It is caused by Trichomonas vaginalis, a protozoan parasite which infects the urinary tract